Are there any recent advances in the treatment of narcolepsy?

The latest method of narcolepsy is based on drugs, supplemented by a combination of mental and psychological diseases. Drugs** are mainly the application of central stimulants, traditional central stimulants include amphetamines, etc., the mechanism is to promote the release of presynaptic monoamine transmitters, inhibit reuptake, long-term application needs to pay attention to its addiction and dependence. At present, the recommended new ** drug is the new central stimulant modafinil, which achieves a wakefulness effect by activating the hypothalamic arousal center, and the conventional ** dose is 200 to 400 mg per day.

Modafinil has mild adverse reactions and is the safest and ideal drug known to date, but it is less effective in cataplexy attacks. Other drugs, such as tricyclic antidepressants and serotonin reuptake inhibitors, can be used for cataplexy episodes, sleep paralysis, hypnagogic hallucinations, etc.

The clinical manifestations are mainly daytime reversal of uncontrollable sleep, cataplexy attacks and nocturnal sleep disturbances. In addition to these main symptoms, patients may also have other concomitant diseases, such as central obesity, precocious puberty, obstructive sleep apnea syndrome, anxiety attacks, migraines, etc., which can affect the patient's work and life. With regard to this, it is mainly proposed that the goals are to minimize excessive daytime sleep, control cataplexy episodes, and improve nighttime sleep.

Through the regulation of psychological behavior and drug intervention, psychological ** and drug ** are equally important. The recommended drugs are as follows: the preferred drugs are modafinil, maindole, sodium -hydroxybutyrate; The second category recommends antidepressant drugs, such as venlafaxine, duloxetine, etc.; There is also a third category of recommended amphetamines and selegiline, which should be noted in the process of medication. In addition, it is equally important to emphasize psychological counselling.

The ** of narcolepsy has the following aspects: First, maintain a regular life: develop good sleep habits, control weight, and avoid emotional agitation.

Second, try to deliberately arrange short periods of sleep during the day to reduce the drowsiness caused by poor sleep at night. Third, try to avoid sports activities that are more dangerous, such as hiking, swimming, fatigue driving, and operating certain dangerous machinery. Fourth, oral medications can be chosen**

For example, the central stimulant, the representative drug is modafinil, which achieves the awakening effect by activating the hypothalamic wakefulness center, and can also take oral selegiline and caffeine. For patients with cataplexy episodes, oral antidepressants may be used. If you don't sleep well at night, zolpidem, dexzopiclone, or clonazepam can be taken by mouth.

Sodium oxybate can ** all the symptoms of narcolepsy, and the efficacy is relatively definite.

Narcolepsy is a chronic sleep disorder, the pathogenesis of this disease is unclear, the main symptoms are characterized by irresistible short-term sleep episodes, generally more common in children or young adults, this condition is generally accompanied by sleep hallucinations, sleep paralysis and cataplexy attacks. At present, the main treatment for this disease is through comprehensive methods such as drugs, acupuncture, physiotherapy and psychological intervention of traditional Chinese medicine. Drugs ** are generally commonly used central stimulants, such as methylphenidate, amphetamine, maindole, etc., the latest central stimulant is modafinil, and other drugs such as selegiline and bupropion.

If the patient has cataplexy, drugs such as desipramine and imipramine can also be selected**. If symptoms of insomnia occur, zolpidem can also be taken by mouth.

According to the recent research literature, it can be known that the latest method of narcolepsy is mainly to regulate the neurotransmitters of the brain to improve narcolepsy, because it is found that the current narcolepsy is related to the lack or abnormal secretion of a neurotransmitter in the brain and hypothalamus, and the symptoms can be improved by adjusting the brain neurotransmitter. Some drugs should also be used clinically, mainly drowsy drugs. It also improves the symptoms of narcolepsy by adjusting sleep during the day.

It is also necessary to let patients follow the doctor's instructions for long-term adjustment and symptomatic treatment through the adjustment of lifestyle habits and psychological **, etc., which can improve the symptoms.

Narcolepsy is manifested as irresistible drowsiness during the day, standing sleep, and inability to fall asleep at night, which seriously interferes with our work, study and daily life. This type of person is often accompanied by obesity, premature development of puberty, nocturnal sleep apnea, poor mood, etc. **：

1. First of all, we must standardize the rules of life, avoid staying up late, take regular naps during the day, and improve the state of awakening; 2. Through psychological counseling, contact with anxiety and depression; 3. Avoid excessive and improper use of sedative-hypnotic drugs; 4. Families and units understand and provide small sleep time during the day.

There is currently no good method for narcolepsy, because so far the diagnosis of narcolepsy is not clear, and the clinical practice can only be carried out according to the symptoms.

TCM dialectical classification of narcolepsy.

In traditional Chinese medicine, the onset of this disease is mainly due to spleen deficiency, heart and liver fire, kidney qi deficiency, etc., which can be regulated by traditional Chinese medicine, and can be regulated by traditional Chinese medicine prescriptions according to different symptoms.

1) Deficiency of heart and spleen.

1.Symptoms Drowsiness, phantom before bedtime, fatigue and palpitations, pale complexion, pale moss, weak pulse.

2 Treatment: Nourish the heart and spleen.

3.If you have abdominal distention, stuffiness, poor appetite, and greasy tongue, add Poria cocos, Huoxiang, and Magnolia bark to aromatize dampness, strengthen the spleen and promote qi;

2) Deficiency of kidney yang.

1 Symptoms of drowsiness, or drowsiness, soreness in the waist and knees, chills and cold limbs, impotence, clear and long urine, frequent nocturia, pale tongue, thin white tongue, and weak pulse.

2 Treatment: Warm and replenish kidney yang.

3 Take the right to drink, if the qi is deficient and the blood is depleted, etc., add ginseng for reuse and add atractylodes and astragalus.

c) Weak temper.

1 Symptoms Drowsiness all day long, yellowish complexion, fatigue and limb fatigue, insomnia and dreams, palpitations and shortness of breath, forgetfulness and irritability, pale tongue, thin white tongue coating, weak pulse.

2 Treatment: Nourish qi and blood, and awaken the brain.

3 You can take the heart-nourishing soup, such as water drinking and stopping in the heart, and those with palpitations and apprehension, add Zhu Ling, betel nut, and Ze Yuan; Those who can't wake up all day long can add Suhexiang, calamus, and Yizhiren to awaken their minds with enlightenment.

4) Biliary fever and phlegm obstruction.

1 Symptoms Drowsiness, dizziness, bitterness and dry mouth, vomiting, chest and flank stuffiness, red tongue, and pulse count.

2 Treatment: Clear the gallbladder and dissolve phlegm.

3 Artemisia Qinqing gallbladder decoction can be taken because of phlegm turbidity and internal resistance, qi reversal does not descend, and those who see the heart is hard and nausea is not removed, add swirling and replacing ochre decoction to benefit qi and stomach, dissolve phlegm and reduce qi; If you can't wake up, you can add Angong Niuhuang Pill to wake up your brain.

Narcolepsy is generally treated with medication. Narcolepsy generally needs to be treated with drugs, and it is generally difficult to be completely cured by drugs.

The onset of narcolepsy is most closely related to the spleen. It is mostly due to the lack of spleen and temper, weakness of the spleen and stomach, lack of middle qi, and lack of yang qi. Due to tiredness and tiredness, poor diet, damage to the spleen and stomach, lack of transportation power, insufficient chemical source, and qi deficiency, unable to nourish the mind and mind, the whole body is weak, the nerves are weak and sleepy.

It can also be caused by weakness of the spleen and stomach, phlegm and dampness trapped in the spleen, and the clear yang does not rise, blinding the clear body.

Narcolepsy is unknown, and it is mainly symptomatic, usually based on drugs, supplemented by a combination of psychiatric and psychological.

1. Drugs**.

1. Central stimulants:

1) Methylphenidate hydrochloride: It is the main drug for hyperactivity attention deficit syndrome in children, and the largest prescription drug for narcolepsy in the world, mainly improving the symptoms of drowsiness in patients.

2) Modafinil: It is the first-line drug for narcolepsy, but the mechanism of arousal promotion is unknown, which may be related to the inhibition of dopamine reuptake, and its main limitation is that it cannot improve cataplexy.

2. Antidepressants:

1) Venlafaxine: It has the dual effects of inhibiting adrenergic and serotonin reuptake, and has become the first-line drug for narcolepsy.

2. Surgery**.

Surgery is generally not required**.

3. Traditional Chinese Medicine**.

Massage and relaxation. The patient is placed in the prone position, relaxes the body, and breathes steadily. Make the body surface fully enjoy the massage, ** after feeling numbness and hot comfort in the head, shoulders and back. 1 time per day, 10 times for 1 course of treatment.

Narcolepsy is not clear, and at present, it is mainly symptomatic, and a comprehensive program based on drugs and supplemented by psychiatric and psychological ** is usually used.

Drugs**. Central stimulants.

Methylphenidate hydrochloride is the main drug for hyperactivity attention deficit syndrome in children, and it is also the world's largest episodic, narcolepsy drug with the largest prescription mainly to improve patients, drowsiness symptoms.

Modafinil is the most episodic, narcolepsy of the pancreas, but the mechanism of prescribing is unclear that it may be associated with depression dopamine, and his main limitation in the community is that it does not improve cataplexy.

Antidepressant. Venlafaxine. It has the bilayered effect of inhibiting the upper limit of glandular velocity, transitivity, and light color in uptake, and has become the first-line drug for the onset of narcolepsy.

Surgery**. Surgery is generally not required**.

Chinese medicine**. Massage and relaxation. The patient is placed in the prone position. Relax your body and breathe steadily. Solid table to fully enjoy the massage. **After feeling that the head, shoulders and back have numbness and comfort, it is better to have a course of treatment ten times a day.